Vol 15, No 2 (2012)

The article presents the authors theoretical and methodological developments in various aspects of employment and maintenance of employment for the disabled in market conditions. The necessity of medical and social support for employment of disabled persons and prevention of labor potential loss of such workers.

A total of 54 patients with recurrent pain after removal of herniated disc have been examined. A new medical technology -intraosseous blockades has been included to all patients in the rehabilitation program for the treatment of recurrent pain and restore movement disorders. The effectiveness of rehabilitation has been evaluated according to the dynamics data of the visual analogue scale of pain, russified MakGill pain questionnaire, the "body scheme" and stimulation electromyography. A significant regression ofpain, restoration of motion function, improving the speed of conduction along the peroneal nerve on the side ofpain in patients with the syndrome of unsuccessful surgeries on the spine have been revealed.

The need in various kinds of rehabilitation of invalids due to disseminated sclerosis was studied with help of analysis of individual rehabilitation programs given to invalids by medico-social expertise institutions of Amur Region. It was detected that many kinds of rehabilitation in patients suffering from disseminated sclerosis have been underestimated.

Gender-specific recurring disability due to disease of the musculoskeletal system in the Irkutsk region in 2006-2010 has been studied. Disability due to diseases of the musculoskeletal system in the Irkutsk region was higher in women with recurring disability than in men (57, 4%) during these years. Recurring disability prevailed in both sexes, but the proportion of men was higher (up to 96.4 % in 2006). The share of recurring disability in the retirement age for both men (from 3.6 to 16.8%) and women (from 10.4 to 44.2%) increased from 2006 -2010.

The topicality of the problem of diagnostic evaluation of speech disorders in clinical practice and conducting medico- social expertise was substantiated. The steps of examination procedure of the patients with speech disorders during the examination process were suggested. Method of evaluation of the named category of patients in the structure of experimental psychological examination was presented separately. The volume of the suggested method corresponds to the conditijns and equipment of the primary affiliated branches of medico-social expertise service.

To compare the effectiveness of fracture risk assessment standard survey methods and FRAX innovative technique FRAX in the elderly, 3152 women members of the Veterans’ Council" of Moscow, not previously examined, and not receiving anti-osteoporotic therapy were examined. Densitometry has been performed to assess bone density as well as testing with FRAX method. 32.4% of patients have a history of atraumatic fractures, and 56.4% - osteoporosis, diagnosed by standard methods of the survey, 72.7% require medical intervention according to testing by the method of FRAX. The sensitivity of FRAX patients requiring treatment according to standard techniques (in patients with osteoporosis without pathological fractures, with osteoporosis in the presence of low-energy fractures and osteopenia in the presence of a pathological fracture) 70.3%, 71.5% and 24.3% respectively. Thus, among the majority of women aged 65-75 years who have not been previously examined and not receiving osteoporosis therapy, revealed violations of bone turnover, fracture history. According to this FRAX method is not always the method of choice for assessing fracture risk in these patients.

The paper shows the possibility of new diagnostic technology, "Litos-System" for the study of solid state structures of the synovial fluid, obtained from elderly patients with coxarthrosis by the wedge-shaped dehydration. It was found that a marker of degenerative-dystrophic lesions of cartilage tissue is spindle-shaped structure in the fascia of the synovial fluid. Comparison of inorganic chemical elements in the fascia of patients with coxarthrosis in the fascia of the synovial fluid showed a fivefold increase in the phosphorus content and a sevenfold in calcium compared to controls. This indicates the destruction of the bone-joint tissue and the accumulation of degradation products that bind phosphorus and calcium salts.

I-ACEs are effective and safe drugs that reduce the activity of the renin-angiotensin-aldosterone system. One of the most studied I- ACEs is perindopril. Its efficacy and safety has been proven by many clinical studies. The effectiveness of perindopril is due to a set of hemodynamic, neurohormonal and metabolic effects, providing a positive prognosis for patients with cardiovascular disease. Therefore, perindopril can rightly be considered one of the drugs for the prevention and performance of various rehabilitation programs for patients with cardiovascular disorders and comorbidity.

The paper shows the results of studies of psychological features of patients with partial and subtotal defects of the ears after the trauma of various origins. In the social survey involved 28 patients aged 25 to 41 years. All the patients underwent reconstruction of the auricle. As a control group randomly 25 men aged 26 to 40 years have been taken. The study was conducted using the WHO QOL questionnaire 100 [6], the adapted version of the I.O Elkina [4]. The presented results of social survey pay attention to assessing the quality of life of patients with defects of the ears before and after surgery as compared with the control group.